Nowadays a New MIS-C Mimicker: Group A Streptococcal Infections

Elvan‐Tuz, Aysegul; Keleş, Yıldız Ekemen; Karadağ‐Öncel, Eda; Yilmaz, Dilek; Özçifçi, Gökçen; Durak, Fatih

doi:10.1097/inf.0000000000003835

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…Therefore, we cannot speculate regarding any potential reporting or selection bias. Although our CLRS did not capture data on types and combinations of coinfections and "complicated respiratory tract infections", on a clinical basis, it was widely reported that these had occurred in high numbers, especially toward the end of 2022 and in early 2023 [ 12 – 16 ]. Unfortunately, these too cannot be shown by means of our CLRS due to its design limitations.…”

Section: Discussionmentioning

confidence: 99%

High burden of acute respiratory tract infections leading to hospitalization at German pediatric hospitals: fall/winter 2022–2023

Doenhardt,

Armann,

Diffloth

et al. 2023

Infection

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Purpose Given reduced immunity levels for seasonally occurring respiratory infections and the experience of an unusually early, severe wave of RSV infections during 2021, a preexisting clinician-led reporting system (CLRS) was updated to prospectively monitor the anticipated high burden of respiratory infections (ARI) in German pediatric hospitals during fall/winter 2022–2023. Methods From September 13, 2022 through March 31, 2023, children hospitalized with ARI as a primary diagnosis were monitored via a national CLRS established by the German Society for Pediatric Infectious Diseases (DGPI). Once a week, the CLRS collected overall number of new hospital admissions, ARI-related admissions according to pathogen (SARS-CoV-2, RSV, influenza, and other), plus number of patients admitted to ICU with ARI as a primary diagnosis. Results With a high participation among children's hospitals across Germany (22.8%), 76 centers submitted 1,053 survey reports. ARI-related hospital admissions showed a steep rise starting in late September 2022 and reached their highpoint in early December 2022 (50.1% of all admissions). In parallel, the average number of newly admitted patients (aNA) with RSV (3.6) peaked, as did those with influenza (2.1) one week later. The average highpoint of ARI patients on ICU (aICU) (2.9) was reached shortly thereafter. Again, RSV (1.6) und influenza (1.2) were predominant pathogens. Conclusion In fall/winter 2022–2023, German hospitals reported a sharp increase in patients with ARIs. While RSV and influenza represented the greatest proportion of ARI, SARS-CoV-2 played a less significant role. Systematic, dynamic collection of ARI data is critical for assessing real burdens on the health care system.

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Section: Discussionmentioning

confidence: 99%

High burden of acute respiratory tract infections leading to hospitalization at German pediatric hospitals: fall/winter 2022–2023

Doenhardt,

Armann,

Diffloth

et al. 2023

Infection

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Interplay between Multisystem Inflammatory Syndrome in Children, Interleukin 6, Microbiome, and Gut Barrier Integrity

Zari,

Redwan,

Raszek

et al. 2024

Immuno

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A severe consequence of SARS-CoV-2 infection that manifests as systemic inflammation and multi-organ involvement is called Multisystem Inflammatory Syndrome in Children (MIS-C). This review examines the possible relationship between gut barrier integrity, the microbiome, dysregulation of interleukin 6 (IL-6) signaling, and MIS-C. Clinical and biochemical features of MIS-C are comparable to those of other hyper-inflammatory syndromes, suggesting a dysregulated immune response. One possible explanation for the systemic inflammation seen in MIS-C patients is the SARS-CoV-2-induced dysregulation of the IL-6 signaling pathway. In addition, new data suggest a reciprocal link between gut barrier integrity and IL-6. SARS-CoV-2 exhibits bacteriophage-like behavior, highlighting the role of bacteria as a reservoir for the virus and emphasizing the importance of understanding the bacteriophagic mechanism of the virus in fecal–oral transmission. The increased translocation of viral products and bacterial toxins may result from disrupting the intestinal barrier and cause systemic inflammation. On the other hand, systemic inflammation can weaken the integrity of the intestinal barrier, which feeds back into the loop of immunological dysregulation. In the context of MIS-C, understanding the interaction between SARS-CoV-2 infection, IL-6, and gut barrier integrity may shed light on the etiology of the disease and guide treatment options. Since children with gut dysbiosis may be more susceptible to MIS-C, it is critical to reinforce their microbiome through probiotics supplementation, and plant-fiber-rich diets (prebiotics). Early antibiotic treatment and the use of zonulin antagonists should also be considered.

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Nowadays a New MIS-C Mimicker: Group A Streptococcal Infections

Cited by 2 publications

References 2 publications

High burden of acute respiratory tract infections leading to hospitalization at German pediatric hospitals: fall/winter 2022–2023

High burden of acute respiratory tract infections leading to hospitalization at German pediatric hospitals: fall/winter 2022–2023

Interplay between Multisystem Inflammatory Syndrome in Children, Interleukin 6, Microbiome, and Gut Barrier Integrity

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